Surgical treatment of osteoporotic trochanteric fractures

Abstract

Introduction. The trochanteric fractures are often encountered in elderly people and make up 3 - 5% of all falls. At the same time, the fracture rate of this fractures increases with age and in patients over 70 years risk for fracture will be ten times bigger than those aged 50-60 years. Over 50% of women and 45% of men over the age of 50 do physiological osteoporosis, older women have a 50% higher risk than men make a fracture. Aim of the study. To establish the correlation between trochanteric fractures and osteoporosis, as well as the implant that will be necessary to be used for the surgical treatment of this fractures. Materials and methods. In this study were included 34 patients with trochanteric fractures, 14 men and 20 women hospitalized in the 2nd Department at the Clinical Hospital of Orthopaedics and Traumatology from January 2015 to December 2015. All patients were treated surgically, with age average of 67 years, the youngest was 46 and the oldest was 85 years old. Results. The study was based on 34 medical cases. The types of implants or endoprostheses used in the treatment of trochanteric fractures were: total cemented hip prosthesis Zimmer in 4 patients, blade-plate 95̊ - 14 patients, 2 cases fixed with DHS (dynamic hip screw), another 2 cases with PFN (proximal femoral nail) and cemented unipolar Austin-Moore prosthesis in 12 cases. In patients with high degree of osteoporosis with total or unipolar cemented prosthesis, were mobilized in second day after surgery, they had no sitting or lying difficulties and maximum in 6 days after surgery they start to walk with pressure on lower limb as soon as the painful postoperative syndrome was solved. In patients operated with blade-plate, DHS or PFN with better bone quality mobilization in the bed was done in the second day after surgery and in the first week after surgery they start to walk in crutches without pressure on the operated limb. Conclusions. Surgical treatment of trochanteric fractures remains the basic method of treatment complications of bed immobilization. Hip replacement is a successful procedure for the elderly, over 75 years with osteoporosis and comorbidities, being live saving, because it makes possible to accelerate patients mobilization and movement, therefore maximized the patients functional outcomes.